Page 9 - Westmark BG 2020

Vision Benefits

Guardian | PPO Vision Plan
The Guardian vision plan provides professional vision care and high quality lenses and frames through a broad network of optical
specialists. You will receive richer benefits if you utilize a network provider. If you utilize a non‐network provider, you will be
responsible to pay all charges at the time of your appointment and will be required to file an itemized claim with Anthem.
Plan Features Guardian
PPO Plan (VSP Network)
Network Non-Network

Copays - Examination $10 n/a
- Materials $20 n/a
Examination 100% up to $39 benefit

Lenses - Single Vision 100% up to $23 benefit
- Lined Bifocal 100% up to $37 benefit
- Trifocal 100% up to $49 benefit
- Progressive $55 copay none
- Lenticular 100% up to $64benefit
- Frequency once every calendar year
Frames - Allowance up to $130, then 20% off up to $46 benefit

- Frequency once every calendar year
Contact Lenses (in lieu of frames & lenses)
- Cosmetic / Elective up to $130 up to $100 benefit
- Visually Necessary up to $210 benefit
- Frequency once every calendar year
Tips for Using Your

Vision Benefits
VSP is the largest network of private-
Finding In-Network Vision Providers
practice eye care doctors in the
Go to www.guardiananytime.com industry. VSP’s network includes
or call (877) 814-8970 and refer to the VSP Network when prompted. 37,000 access points nationwide.
Most of the U.S. population lives
within four miles of a VSP provider.

Hearing Aids

Guardian | Hearing Savings
The Guardian vision plan participants have access to quality hearing care and savings on name brand hearing aids through a
national network of preferred providers. Access to all name brand hearing aid technology with a $70 allowance for exams and a
$500 allowance for hearing aids.

To Start the Process
Call EPIC at (866) 956-5400, a hearing counselor is available for registration, help finding a provider or to
answer any questions.

9